CAPTEM Archives

21 Apr 2024

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Chemotherapy for Neuroendocrine Neoplasms

Treatment5-Fluorouracil (5-FU), Afinitor, Cancer research, Capecitabine (Xeloda), CAPecitabine TEMozolomide (CAPTEM)., CAPTEM, Carboplatin, Chemotherapy, Cisplatin, Etoposide, Everolimus, FCarboSt, FOLFIRI, FOLFOX, High Grade NEC, Irinotecan (Campto), Mixed Neuroendocrine Non-Neuroendocrine Neoplasms (MiNEN), Neuroendocrine cancer, Neuroendocrine carcinoma (NEC), Paclitaxel (Taxol), Poorly differentiated, PRRT, Somatostatin analogues, Streptozotocin (Zanosar), Sunitinib (Sutent), Temozolomide (Temodal), Vepesid), Well differentiated, XELOX. Oxaliplatin (Eloxatin)

By Ronny Allan – Living with Neuroendocrine Cancer Chemotherapy has a long and complicated history in the management of Neuroendocrine Neoplasms (NENs) (an umbrella term for both Neuroendocrine Tumours (NET) and Neuroendocrine Carcinomas (NEC)). Unlike many other cancers, most well‑differentiated NETs are relatively resistant to traditional cytotoxic chemotherapy. However, chemotherapy remains an important option for specific subtypes, particularly higher‑grade disease, and certain anatomical sites. There's a myth that circulates the NET patient groups along the lines of "chemotherapy does not work for NETs". That's not entirely true or at best totally out of context. However, it's true to say that…

16 Jan 2024

By Ronny Allan

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Randomized Phase II Trial of Postoperative Adjuvant Capecitabine and Temozolomide Versus Observation in High-Risk Pancreatic Neuroendocrine Tumors (SWOG S2104)

Clinical Trials and ResearchCAPTEM, Pancreatic NET (PanNET)

What is SWOG S2104? A Randomized Phase II Trial of Postoperative Adjuvant Capecitabine and Temozolomide Versus Observation in High-Risk Pancreatic Neuroendocrine TumorsPancreatic neuroendocrine tumors (pNETS) account for about 1-2% of all the pancreas tumors for which resection is the only curative intent modality, however, despite surgery, many patients will experience recurrence. Tumor size, positive lymph nodes and higher grade are prognostic factors for recurrence. The U.S. Neuroendocrine Tumor Study Group published a predictive score (Zaidi score but also see inclusion criteria) demonstrating that tumors with a score ≥6 had a 33% likelihood of recurrence by 24 months. Furthermore, it is…

15 Jun 2022

By Ronny Allan

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CAPTEM for Neuroendocrine Tumours

Clinical Trials and Research, TreatmentAdvanced neuroendocrine cancer, Capecitabine (Xeloda), CAPecitabine TEMozolomide (CAPTEM)., CAPTEM, Chemotherapy, Clinical trial, Pancreatic NET (PanNET), Temozolomide (Temodal)

What is CAPTEM? Capecitabine is an oral drug used alone or with other drugs to treat certain types of colorectal cancer and breast cancer. It is also being studied in the treatment of other types of cancer including in combination with a second drug. Capecitabine is taken up by cancer cells and breaks down into fluorouracil, a substance that kills cancer cells. Also called Xeloda. Note -Capecitabine is an oral Oral 5-FU prodrugs which are medications designed to be taken by mouth and converted into the active chemotherapy agent 5-flourouracil (5-FU) within the body, aiming for higher tumour selectivity and…

07 Mar 2022

By Ronny Allan

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Clinical Trial: Testing the Use of Chemotherapy After Surgery for High-Risk Pancreatic Neuroendocrine Tumors

Clinical Trials and Research, TreatmentCAPecitabine TEMozolomide (CAPTEM)., CAPTEM, Chemotherapy, NETest, Pancreatic NET (PanNET), Surgery

An interesting trial centred on SW USA. The use of CAPTEM following surgery in high-risk pancreatic NETs (G2/G3 well-differentiated). Also includes the use of NETest at 3 time points, which is very interesting considering the recent withdrawal of Chromogranin A from US NET Guidelines. (Read about NETest here). Randomized Phase II Trial of Postoperative Adjuvant Capecitabine and Temozolomide versus Observation in High-Risk Pancreatic Neuroendocrine Tumors (S2104) is a recently activated National Clinical Trials Network randomized phase II trial designed to compare CAPTEM chemotherapy versus observation following resection of pNETs (see Figure 2). Patients with well-differentiated grade 2 or 3 (Ki-67 up…

20 May 2016

By Ronny Allan

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Clinical Trial: PRRT and CAPTEM combination therapy

Clinical Trials and ResearchCapecitabine (Xeloda), CAPecitabine TEMozolomide (CAPTEM)., CAPTEM, CONTROLNETS, Peptide receptor radionuclide therapy (PRRT), PRCRT, PRRT, Temozolomide (Temodal)

Updated 2026: A more recent, mature publication from the same Australian CONTROL NET programme has confirmed the earlier signal: combining PRRT with CAPTEM produces high response rates, particularly in pancreatic NETs, but at the cost of substantially increased haematologic toxicity and no clear, durable survival advantage strong enough to change guidelines. Highlights Efficacy outcomes from PRRT+CAPTEM in NENs remain unclear. PRRT/CAPTEM was feasible and well tolerated in this randomized trial. SBNETS: No PFS difference between PRRT/CAPTEM and PRRT. PNETs: PFS/ORR for PRRT/CAPTEM numerically higher than CAPTEM on extended follow-up. Randomized studies in uncommon tumours are essential to optimise practice. Interesting…

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